Recommendation 196

Knowledge and skills framework for nursing

The Knowledge and Skills Framework should be reviewed with a view to giving explicit recognition to nurses’ demonstrations of commitment to patient care and , in particular, to the priority to be accorded to dignity and  respect, and their acquisition of leadership skills.

Employers have the freedom to use the Knowledge and Skills Framework to develop their own local arrangements to ensure that dignity, respect and leadership is fully reflected in staff training and development and that capability, learning and development is part of local appraisal systems.  This is made clear in the national Agenda for Change agreement which links pay progression more strongly to performance from March 2013, for more than 1.1 million NHS staff.  NHS Employers are already working hard to help employers realise the benefits of the new national agreement on performance.

The Department of Health will commission NHS Employers to encourage NHS organisations to strengthen their local knowledge and skills frameworks so that there is a clear line of sight between the NHS Constitution, the values and behaviours set out in the ‘6Cs’ of Compassion in Practice, the vision and strategy for nursing in England, and local values, performance and appraisal systems.

In addition, the Nursing and Midwifery Council’s standards for competence require nurses to demonstrate their potential to develop management and leadership skills during their period of preceptorship after registration and beyond.  This means that the public can trust the newly registered nurse to be an autonomous and confident member of the multi-disciplinary or multi-agency team, and to inspire confidence in others. Nurses can then become more involved and responsible for the planning and delivery of care and improving future services.  NHS Employers will encourage NHS organisations to make the necessary links with the work the Nursing and Midwifery Council is leading on revalidation as they develop new local performance and appraisal arrangements.


With Health Education England, NHS Employers has developed a mapping tool to allow local organisations to map their values to those in the NHS Constitution. NHS Employers has also produced guidance for employers linking pay progression, appraisal and performance management to values and commitment to patient care. This includes a number of resources to support employers including good practice case studies and a model policy. Further resources including case studies and podcasts will continue to be developed during the year.